Vinflunine

Vinflunine is a novel fluorinated vinca alkaloid that has been approved for the treatment of second-line transitional cell carcinoma of the urothelium and is being tested in other cancers. It is the first microtubule inhibitor that has shown to improve survival in this disease. Vinflunine is produced semi-synthetically from a precursor extracted from the periwinkle plant.

Mechanism of action

Vinflunine acts by inhibiting microtubule dynamics, which are crucial for mitosis and cell proliferation. Its mechanism of action involves the suppression of microtubule dynamics by targeting tubulin into the vinca domain.

Clinical use

Vinflunine has been approved in Europe for the treatment of bladder cancer. It is used as a second-line treatment following failure of a platinum-containing regimen. It has also been tested in non-small cell lung cancer, breast cancer, and malignant pleural mesothelioma, but not yet approved for these indications.

Side effects

The most common side effects of vinflunine are constipation, nausea, fatigue, neutropenia, and anemia. Severe neutropenia can be prevented with granulocyte colony-stimulating factor support. The use of vinflunine is contraindicated in patients with severe liver disease, recent history of cardiovascular disease, and uncontrolled hypertension.

References

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See also

• Vinca alkaloid
• Microtubule inhibitor
• Transitional cell carcinoma of the urothelium

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